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� <br />� <br />i ELECTRICAL PERMIT APPLICATION <br />� CiTY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />I 425-257-8810 - FAX 425-257-8857 — ww�v.everettwa.org <br />APPLIC�TIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />Z`�oZ UJ 1'�'�G��1ru Ui<��J 'Dr'. �� <br />PROJECT ADDRESS <br />� <br />�: ����t---( `�c_.<_�r��� �-Ir:� �4��11��;��Y�� Z�G?_ l� I�1C�v�a1Cti�i-�iU I <br />Owner Mail �ddress QI 1 t i p I Phone I <br />Y ��ii�✓-�� ���C�J �Li � <br />Tenant Matl Address City <br />�7� <<�i��f���� i��«<�( r. �� P� I�;k I 3zt�� 4 <br />�Electncal CoNractor �dail ddress Cily <br />�;� �� I� �T �) �?�1 �� f C� <br />State License Number <br />Proposed Use of Budding <br />c1atNZlp <br />State/Zip <br />Pho e <br />�G�'�� <br />LU�; �«�5�� '.� <br />Phone <br />I <br />I �z' C � � <br />� � ; <br />Contract Price ot Work ' <br />Contact Person (Plan ReviEw) <br />�� Descnplion ot work to Be Done- �- �� J ,� � � �� � � � �� � � 1� � �('��l ) �I V � � �� 1 a� 1 �,� � <br />-`-� �(� ����� ��7 C' i rC� u rt S�( 3�1 �� t Z� �� r�n� �� <br />�, ��_�YC'.�l.l�. __ �, <br />i I <br />I, NOTE: WIRING IN NON-DW[LLINGS IS REQUIRED TO FEE II <br />BE IN RACEWAYS, MC OR AC CABLE. � <br />I �� ..' V i <br />' CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 '. <br />I1 hereby ceAJy that I have iead and examined this applrca6on and know tho same lo be true and <br />correct All prowsions ollau�s and ordinances governmg flns fypo ol u�ork will he complefed <br />i� �vhefhcr spe�r/red he�ein or nof. ihe r�ranfing o/ a pernuf does nof vesurne fo give authonty fo <br />, violafe or cancel fhe provisions ol any other slate or local la�v regula(mg construction or fhe <br />'i peAcnnance o/ construc6on. That I am au:ho�ized by fhe o�vnei ol fh�s property !o pedorrn fhe <br />work lor u hich application Is r»ade and I compty wrth the Sfate Contractors Law 78.27 RCW and <br />� 296200 WAC. � <br />/,- <br />� / i��j� <br />. � 'Signa�ure � •. .i <br />��� ��I <br />'���3 � <br />; <br />